The episode begins with SpongeBob and Patrick singing at the Krusty Krab. Squidward becomes very annoyed, so he goes to tell them to stop. Just as he reaches the door, Squidward's face is hit by SpongeBob, who accidentally slammed the door on his face. Squidward ends up needing surgery after what SpongeBob did. After undergoing plastic surgery for two weeks, Squidward suddenly becomes handsome.
At first, everything was going fine, like getting comments from both females and males, signing autographs and getting a ride home in a limousine.
But all that changes when Squidward's fans go crazy and take his stuff to the point where they won't leave him alone. Everything is too much for Squidward so he goes to SpongeBob for help. Squidward wants to become his normal self, so he and SpongeBob race to the Krusty Krab with the crowd following them. Mr. Krabs becomes overjoyed to see everyone at the entrance, and begins to name all the prices. While he does that, Squidward tells SpongeBob to slam the door against his face in order to make him normal again. SpongeBob doesn't want to do it, but Squidward threatens to hurt SpongeBob if he doesn't hurt him. So he begins to slam the door against Squidward's face repeatedly, but it only makes Squidward even more handsome. Suddenly, the flying fish's other bowling shoe, falls out of the top, and SpongeBob, who was alarmed by it, pushes Squidward out of the way. SpongeBob's push sends Squidward flying dramatically and causes him to hit a pole, while the shoe just bounces off of SpongeBob's head. The blow from the pole causes Squidward's face to become normal again. The crowd, who is disappointed to see Squidward not handsome anymore, begins to walk away miserably, but Mr. Krabs, who is unhappy to see his beloved customers go away, tries to return Squidward's handsomeness by slamming the door repeatedly against his face.
I can turn into a skyscraper!
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In this episode, SpongeBob says, "Handsome. But she spelled it wrong." after Squidward asks what Sadie had called him a moment before. This was an inside joke, where the word, "Handsome" was missing the "d" on the storyboards of that scene.
Originally, the thing that was going cause Squidward to get a broken face was a truck.
This was Charlie Bean's only episode as writer and storyboard director.
Squidward will have a change in appearance after a head injury into a baby in "Squid Baby."
In the scene where SpongeBob is clipping his toenails, there is incense burning in the background.
During the hospital scene, there is a television set in Squidward's room which Purple Doctorfish said "for the patient's enjoyment," which Squidward can't possibly watch due to the bandages on his head.
Squidward's head was really broken twice in this episode because before Squidward's face was broken in the beginning, he was shown as a thermometer, and when the mercury was reaching to the boiling point, his forehead breaks off.
This is the first time Squidward is on a title card.
The second was in the title card of a later episode called "Oral Report."
The second time they are seen, SpongeBob is wearing his hat.
This is one of the few occasions when Squidward was acting like a friend to SpongeBob.
On Squidward's second "handsome phase" it shows that he wears a belt on his shirt.
Running Gag: Every time Gill Gilliam tries to cut the bandages, SpongeBob shouts: "Wait!" or "Hold it!"
In this episode, Squidward plays his clarinet well, while in others, he is shown to be very bad at it.
During the scene where SpongeBob pushes Squidward out of the way to avoid the other falling bowling shoe (and reverting him back to his old self), the opera Pagliacci's aria "Vesti la giubba" by Ruggero Leoncavallo was heard.
In the patient's room, when SpongeBob watches television, it shows Fred as a doctor with a female fish.
When SpongeBob is hitting Squidward repeatedly with the door, you hear some cracking noises.
This could mean he is breaking some bones or his face.
Squidward's second "handsome face" became a famous meme and running gag on the internet, being especially used as Facebook profile picture or in other social sites and galleries.
It has also been used in the One Direction fandom, where a mathematical formula shows One Direction's Zayn Malik being added to Squidward's "even more handsome" stage, resulting in one of the guys from The Wanted.